Unless you or someone you know has needed the services of a rheumatologist, chances are you have no idea what they do. Rheumatology is a medical specialty dealing with problems of the joints, soft tissue, and some auto-immune diseases. The main reason people go to see a rheumatologist is arthritis – and over the past 22 years Dr David Bossingham has helped many thousands of people affected by these conditions in Cairns and far north Queensland. David moved to Cairns from Nottingham in 1992 – and now he’s about to retire. His colleagues and many current and former patients gave him a fond send-off yesterday.
David has long been fascinated by immunology – the study of the immune system – and that fascination drew him to rheumatology, a field of medicine in which there have been tremendous advances, and increasingly, the prospect of cures. Dr Bossingham reflects on those advances, and his 22 years in Cairns in an interview aired on ABC Far North today.
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This year the Red Cross marks 100 years of service to the communities of Australia. This morning I sat down for a yarn with a group women in Cairns who, between them, have given almost 150 years of service as Red Cross volunteers in far north Queensland. They’ve recently returned to the Lake Street site that has been home to the Red Cross since the early 1960s. But the old green two story HQ building is lone gone, replaced by a flash new multi-level well-being centre that will be officially opened next Monday.
One of the main Red Cross services here in FNQ is to provide accommodation and support services for people who’ve come to Cairns for hospital or medical treatment, often from remote communities on Cape York or in Torres Strait and the Gulf country. The new centre can hold up to 88 people, as well as office space for the local branch and the regional HQ. It will be used as a training venue for Red Cross College, and as an emergency recovery centre during emergencies and disasters.
And the new building proudly carries the name of the region’s longest serving Red Cross volunteer – Pat Gosper, who joined in 1947. LISTEN – meet Pat and her fellow volunteers and explore a new Cairns landmark – Pat Gosper Place.
Meet Adam Garnett – 45 years old, husband, father of four lovely kids, and the recipient of a donated organ.
You may already know Adam. He was one of many government workers who came to the aid of Cassowary Coast communities in 2006 when Cyclone Larry paid us a visit. Like many of us hit by that disaster, Adam didn’t feel too good, and put it down to tiredness and the huge workload of the cyclone recovery effort. But then some tell-tale symptoms showed themselves, and the doctor told Adam they were signs of kidney disease.
He was put on dialysis – something he learned to do for himself – and was told he might wait five years or more for a transplant. That’s because organ donation rates are low in Australia, and only a small percentage of donors die in circumstances where donation is viable.
But it only took a year – he got the call in the middle of the night and was in a Brisbane hospital next morning being wheeled in to an operating theatre where, waiting in what looked like an ordinary blue esky, was the kidney that would change, and save, his life.
Before his illness, Adam had decided he would say yes to the organ donor option on his driving licence. Not surprisingly, he hopes you will make that decision too, and make sure your family knows about your wishes. It is, Adam says, a chance to be a hero. LISTEN to Adam’s story here
Midway through 2011, doctors in far north Queensland began seeing people presenting with nasty ulcers that were turning surrounding tissue into sludge. It was an outbreak of what’s known locally as Daintree ulcers – a condition that’s been known for many years now, but no-one’s really sure how humans acquire it, and thus how it can be prevented.
By the end of that year, GPs & surgeons had treated many cases – with strong antibiotics and surgical procedures. It can be cured, but it can take a long time and sometimes there’s lasting damage. In FNQ, Daintree ulcers occur only in a very contained and specific area of the Daintree region – no-one yet knows why. It’s a more common problem in parts of west Africa – so the common theme is tropical climates. But the mystery deepens – these ulcers also occur in the very not tropical East Gippsland district of Victoria, where they’re called Bairnsdale ulcers. The World Health Organisation now calls them Buluri ulcers, in acknowledgement of their incidence in west Africa.
We know what causes them – a bacteria called mycobacterium ulcerans. It’s a bacteria commonly found in the lush tropical world, but for reasons no-one can yet explain, they cause flesh-eating ulcers in just a few relatively small, quite specific but widely separated areas, one of them not at all tropical. We don’t know how the bacteria gets into humans. Mosquitos, march flies, possums and other critters have all been suspects – there’s no definitive answer and some believe the rainforest itself could be the vector. And we don’t know why some people who’ve been exposed don’t get sick, while others develop serious ulcers.
A team of researchers is in FNQ at the moment trying to answer those questions. They hope to develop a blood test to detect exposure and help us prevent future outbreaks. Professor Paul Johnson, from Melbourne University & Austin Health is one of the researchers. LISTEN to my interview with Paul here
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This Sunday, Chris Wiles will get up early and head from his Babinda home to the Innisfail post office. When the clock strikes six, Chris will get on his bicycle and ride the 90 or so kilometres to Cairns, a journey he hopes to complete by around noon. It’ll be a hot day, and it’s no easy ride – there are some serious uphill stretches on the Bruce Highway that will test his fitness and resolve.
Chris is taking part in the annual Ride For Muscular Dystrophy – an event that raises awareness about the various forms of this debilitating medical condition, and raises funds to help people living with MD in Queensland. http://www.everydayhero.com.au/event/ride4md2013
The ride actually takes place in Brisbane, but the cost of travel was prohibitive, so Chris and his family decided to hold a one-man ride here in far north Queensland – linking with a team competing in the Brisbane event, Team Mad Dog Wiles. http://www.everydayhero.com.au/team_maddog_wiles
Muscular dystrophy is something the Wiles family first heard of earlier this year, when Chris’s seven year old son Harper was diagnosed with Becker Muscular Dystrophy. He’s doing OK at the moment, but his future now includes some scary possibilities.
Muscular dystrophies are genetic disorders that can cause muscle wasting and weakness, loss of strength, possibly even life-shortening or life-threatening conditions. There’s no cure, and much yet to be learned about the condition and treatments. Duchenne muscular dystrophy (DMD) is probably the best known and more severe form of dystrophy, Becker (BMD) is considered a milder form with a much slower and less predictable progression.
Every year, somewhere between 150 and 200 babies are born on Cape York Peninsula. Hang on – that’s not right. They’re born into Cape York families – but those babies are born in Cairns. Queensland Health requires pregnant mothers to head to Cairns at around 36 weeks into their pregnancy – especially mothers thought to be at high risk of medical complications in the late stages of pregnancy and during birth. The current thinking is it’s better to have births at far north Queensland’s biggest hospital, eliminating the need for a late emergency medical evacuation to Cairns if things start to go wrong.
It may be sound medical reasoning, but it can be a real hardship for indigenous women. Despite support schemes and subsidies, the temporary move to Cairns can be costly, lonely, a real disconnect from the extended family support at home. And it tends to further entrench an attitude about health care – that it’s somehow separate from the daily lives of indigenous people. We understand Queensland Health is considering introducing birth facilities at one Cape York hospital, not eliminating the need to leave home but reducing the physical & cultural distance.
During pregnancy and after the birth of their child, Cape York indigenous mums are supported by services provided by various organisations, including Apunipima Cape York Health Council. http://www.apunipima.org.au/ Its teams realise that the much used “close the gap” health slogan can only have meaning if health care is present in remote indigenous communities, and is delivered in socially and culturally appropriate ways.
Rachel Sargeant leads the Apunipima Maternal & Child Health team. She works closely with her indigenous colleague, Daphne De Jersey, the Apunipima child & maternal health worker in Mapoon on north-west Cape York.There are many challenges – high rates of smoking and drinking during pregnancy, STIs, gestational diabetes, and more. But Daphne, Rachel and their colleagues are making headway. LISTEN Click on the red arrow to hear Rachel and Daphne talk about their work caring for the mums and babies of Cape York.
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AEDES AEGYPTI MOSQUITO – CARRIES DENGUE FEVER IN FAR NORTH QUEENSLAND
You’ve got to look after yourself in the tropics, The climate that makes far north Queensland such an attractive place to live also makes it a great place for diseases and the creatures that carry them. Don’t worry – a few basic precautions will keep you safe – and we have world class experts researching and practising tropical medicine.
The main concern in FNQ these days is Dengue fever – a viral illness spread by mosquito bite. The disease is not endemic here, but one of the mosquitos that can carry it is present – Aedes Aegypti. Travellers arriving from Papua New Guinea or south-east Asia bring dengue back with them, the local mosquitos bite them and spread it around. This wet season we’ve had 112 cases of Dengue in the Cairns region. There’s no cure, but prevention is very effective – repellent and keeping your property clear of potential mosquito breeding sites are critical. Read more about dengue in tropical Queensland here http://www.health.qld.gov.au/dengue/
There’s some great work being done here to reduce the risk of dengue from the Aedes Aegypti mosquito, and a very effective program to keep its much more dangerous relative – Aedes Albopictus – out of Australia. But Federal funding for that is about to run out and scientists are worried about the health risks if it doesn’t continue.
THE ASIAN TIGER MOSQUITO – AEDES ALBOPICTUS
Aedes Aegypti is a tropical mosquito – and so the Dengue risk is confined to north Queensland. But Aedes Albopictus – also known as the Asian Tiger mosquito – can survive outside the tropics, in the more temperate zones of southern Australia. This, according to the experts, means that the area in which you could be bitten by a Dengue-infected mosquito could extend to Brisbane, and well into New South Wales or Victoria in the future. And Albopictus can also carry a nasty tropical disease called Chikungunya.
Currently, the Tropical Public Health Service in Cairns runs an Asian Tiger mosquito control program in the Torres Strait.The mozzies used to be found in significant numbers on Thursday and Horn islands, but are now rarely seen there. But one was found recently on a ship in Cairns, and they’re routinely present in near neighbours Papua New Guinea and Solomon Islands. If they get established on the Australian mainland, they will spread, and scientists tell us that will require major new control strategies at local, state and federal level.
LISTEN Click on the red arrow to hear Professor Scott Ritchie of James Cook University Cairns and Dr Greg Devine of the Tropical Public Health Service Cairns talk about the current program and make the case for it to continue.
LISTEN Click on the red arrow to hear Scott & Greg talk about the current Dengue outbreaks in Cairns and some the programs to control the spread of the disease
Scott Ritchie is a member of the Aedes albopictus technical advisory committee and the National Arbovirus and Malaria Advisory Committee..
Greg Devine is Director of Medical Entomology with Tropical Public Health Services in Cairns.
DENGUE ZONES AROUND THE TROPICS
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